Elevated risk for developmental disabilities in children with congenital heart defects.

BACKGROUND: This study examined risk for developmental disabilities in preschool-aged children with a congenital heart defect (CHD) at the population level. METHODS: Statewide birth, birth defects, and preschool developmental disability records were integrated. The final sample included 1,966,585 children (51.0% male). Children were grouped by type(s) of CHD: critical CHD, noncritical CHD, atrial septal defect, or no major birth defects (groups were mutually exclusive). RESULTS: Children with a CHD (any type) were at increased risk for developmental disability (any type) (RR 2.08, 95% CI 2.03-2.14, P < .001). Children in the critical CHD, noncritical CHD, and atrial septal defect groups were at increased risk for developmental delay, intellectual disability, language impairment, other health impairment, and any disability. Children in the atrial septal defect group were at increased risk for autism spectrum disorder and speech impairment. For all CHD groups, risk was greatest for other health impairment and intellectual disability. CONCLUSIONS: Increased risk for developmental disabilities was identified for children with less severe CHDs as well as for children with more severe (critical) CHDs. All children with CHDs should be closely monitored so that appropriate interventions can be initiated as early as possible to maximize learning outcomes.

A year in words: The dynamics and consequences of language experiences in an intervention classroom.

Children from low SES backgrounds hear, on average, fewer words at home than those from high SES backgrounds. This word gap is associated with widening achievement differences in children's language abilities and school readiness. However relatively little is known about adult and child speech in childcare settings, in which approximately 30% of American children are enrolled. We examined the influence of teacher and peer language input on children's in-class language use and language development in an intervention classroom for low-SES, high-risk 2- to 3-year-olds. Over the course of a year, day-long recordings of the classroom were collected weekly with LENA recorders. Using LENA software algorithms, we found that language input from peers was positively related to children's in-class language use, both in-the-moment and over the course of each day, as were the number of conversational turns in which children and teachers engaged Both peer input and conversational turns with teachers were also positively related to children's language development rates, as indexed by increases in vocabulary size. Together these results indicate the importance of child-specific rates of classroom language input in the language development of high-risk, preschoolers.

Lead Exposure and Developmental Disabilities in Preschool-Aged Children.

CONTEXT: Lead is a preventable environmental toxin that has been previously associated with deficits in cognition, academic performance, attention, and behavior in children. Very few studies, however, have examined the relationship between exposure to lead and documented developmental disabilities. OBJECTIVE: This study examined the relative risk of lead exposure on developmental disabilities in preschool-aged children. DESIGN: A statewide lead surveillance data set containing blood lead level (BLL) was integrated with another statewide data set containing developmental disability classifications for special education placement for preschool-aged children. PARTICIPANTS: The participants were the 85 178 children (average age 2.6 years) whose records in both data sets were able to be linked. Forty-six percent of the participants had an identified developmental disability. MAIN OUTCOME MEASURE: Developmental disability classification served as the main outcome measure. RESULTS: A high BLL, defined as 5 µg/dL or more, was associated with significantly increased risk for developmental disabilities (risk ratio [RR] = 1.04; 95% CI = 1.01-1.08), particularly intellectual disability (RR = 1.58, 95% CI = 1.10-2.25) and developmental delay (DD; RR = 1.11, 95% CI = 1.06-1.17). CONCLUSIONS: The results of this study are consistent with previous research identifying an association between lead exposure and numerous intellectual and educational outcomes and demonstrate that high BLL is associated with meeting eligibility criteria for developmental disabilities in young children. Continued research, surveillance, and prevention efforts are needed to further reduce the negative impacts of lead on individuals and society. Reducing or eliminating lead exposure would improve outcomes for individual children (eg, better academic performance) and reduce the burden to society (eg, lower enrollments in special education systems).